Tonga's head of health has expressed frustration at the lack of assistance in repatriating citizens stranded abroad.
Several hundred Tongan nationals are currently overseas, including a small cluster of surgical patients and their carers who have been stuck in India since Tonga's borders closed in March.
The Ministry of Health wants them to be repatriated but its CEO, Siale 'Akau'ola, said he was extremely frustrated that no viable pathway could be found for the patients.
"We have difficulty in repatriating back our folks from India, because no one can help us. It is quite a bit frustrating!" he told a regional conference at the Fa'onelua Centre on Thursday.
He identified an urgent need for strong collaboration with regional organisations such as the Pacific Island Forum Secretariat and the Pacific Commission.
"These institutions, in my view, in the midst of covid-19, need to be strengthened," he said.
"Because I think we need to go to them and ask for help and they should be able to have the capacity to help us. I think we need to put resources where we can just ask the Suva office to help us with this.
"We have to go begging all over the world for things like that, because there is no capacity in the Pacific," Dr 'Akau'ola said.
He did not confirm how many Tongans were stranded in India at the moment, nor how they were surviving.
Since last year Tonga had been sending patients to India for surgergy that couldn't be done locally. Their treatments were facilitated under a partnership with the Apollo Hospitals in India.
Some also received oncology, radiation and chemotherapy. The cost of being treated in India, was roughly a third of what it cost for the same treatment in New Zealand and Australia.
Fiji and Samoa had also been sending patients for treatment in India for years.
In his presentation to the conference on the 2050 Strategy for the Blue Pacific Continent on Covid-19 and drivers of change, Dr 'Akau'ola also spoke about how the pandemic highlighted the vulnerability of the health system in Tonga and other small island states.
"For me trying to build and maintain resilience against shocks like covid-19 is a fairly complex process. It is almost impossible for a lot of small countries to sustain any kind of response like that.
"We need to collaborate. We need to work in solidarity as a group of Pacific Islands States. And I think it further emphasises a need to deepen the duties and therefore the relevance of regional organisations that will work directly with Pacific Island country leaders."
Dr 'Akau'ola highlighted opportunities for health, including transforming health systems to make them more flexible and resilient to shocks and disasters.
There are over 2800 people registered with the Tonga government for repatriation, with 1500 in New Zealand, 500 in Australia, and the remainder in other countries, including India.
However, to date, Tonga has repatriated only 207 people - 57 from Fiji and 150 from New Zealand, which are considered low risk countries.
Tongans stranded in countries like India have not been able to make their way to low risk countries near Tonga due to international travel restrictions.